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General medicine
Prevention of cardiovascular disease and renal failure in type 2 diabetes: sodium-glucose cotransporter-2 (SGLT2) inhibitors
  1. Jack W O’Sullivan1,2
  1. 1 Division of Cardiology, Department of Medicine, Stanford University, Palo Alto, California, USA
  2. 2 Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
  1. Correspondence to Dr Jack W O’Sullivan, Division of Cardiology, Department of Medicine, Stanford University, Palo Alto, CA 94305, USA; jackos{at}stanford.edu

https://doi.org/10.1136/bmjebm-2019-111231

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    End-stage renal failure is a common and devastating consequence of type 2 diabetes. Sodium-glucose cotransporter-2 (SGLT2) inhibitors, in combination with angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor antagonists (ARBs), reduce cardiovascular events and deterioration of renal disease in patients with type 2 diabetes and renal impairment.

    Type 2 diabetes is a global epidemic.1 It is the third most frequent cause of disability in high-income countries and the most common cause in most low-income countries.1 Much of this disability relates from renal impairment caused by uncontrolled blood glucose levels; as many as 40% of patients with diabetes will develop kidney disease.2 The presence of renal impairment in patients with type 2 diabetes has many consequences—chiefly, these patients are at substantial risk of cardiovascular disease and, often in <10 years, progress to end-stage renal failure.3 Currently, the only medicines approved for renoprotective in patients with diabetes are renin–angiotensin blockers, namely ACEI and ARBs.4 The CREDENCE trial tested the effect of …

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    Footnotes

    • Contributors JWO’S is the sole contributor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.